Nephrol Dial Transplant (2000) 15: 1029-1034
© 2000 European Renal Association-European Dialysis and Transplant Association
Randomized trial of high-flux vs low-flux haemodialysis: effects on homocysteine and lipids
1 Division of Nephrology, London Health Sciences Centre, London, Ontario, 2 Clinical Epidemiology Unit, Ottawa Civic Hospital Loeb Research Institute, Ottawa, 3 Division of Biochemistry, Ottawa Hospital, Ottawa, 4 Division of Nephrology, Ottawa Hospital, Ottawa, and 5 Divisions of Respirology and Critical Care, Ottawa Hospital, Ottawa, Ontario, Canada
Background. Uncontrolled studies have found that high-flux haemodialysis favourably modifies homocysteine and lipid profiles. We sought to confirm these findings by carrying out a randomized prospective comparison of high-flux and low-flux polysulphone in chronic, stable dialysis patients.
Methods. Forty-eight patients were randomly assigned to either high or low-flux dialysis for 3 months. Serum levels of homocysteine, lipoprotein (a), and lipids were compared between the treatment groups at monthly intervals.
Results. All patient characteristics and laboratory variables were equally distributed between the groups at baseline. Over the study duration, we observed no differences between high- and low-flux treatment groups for the following outcomes: pre-dialysis homocysteine, lipoprotein (a), total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides (all P>0.05). Geometric mean (interquartile range) homocysteine at baseline was 20.0 (16.8–24.5) and 19.5 (15.3–22.0) µmol/l for the high-and low-flux groups respectively (P=0.80), and levels did not change significantly during the study. We did demonstrate a more pronounced intradialytic effect of high-flux dialysis on homocysteine levels, which fell during dialysis by 42%, compared to 32% with low-flux dialysis (P<0.001).
Conclusions. In this randomized controlled trial, the effects of high-flux and low-flux haemodialysis on homocysteine and lipid profiles were comparable. The greater intradialytic effect of high-flux dialysis on homocysteine did not translate into a significant difference in pre-dialysis levels after 3 months of study.
Keywords: haemodialysis; homocysteine; polysulphone; prospective studies
Correspondence and offprint requests to: Dr Andrew A. House, Division of Nephrology, London Health Sciences Centre, University Campus, PO Box 5339, Stn Ctr CSC, London, Ontario, Canada N6A 5A5.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  B. L. Urquhart, D. J. Freeman, M. J. Cutler, R. Mainra, J. D. Spence, and A. A. House Mesna for Treatment of Hyperhomocysteinemia in Hemodialysis Patients: A Placebo-Controlled, Double-Blind, Randomized Trial Clin. J. Am. Soc. Nephrol., July 1, 2008; 3(4): 1041 - 1047. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. W. Mudge, R. Rogers, P. Hollett, B. Law, K. Reiger, J. J. B. Petrie, L. Price, D. W. Johnson, S. B. Campbell, N. M. Isbel, et al. Randomized trial of FX high flux vs standard high flux dialysis for homocysteine clearance Nephrol. Dial. Transplant., October 1, 2005; 20(10): 2178 - 2185. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Wanner, U. Bahner, R. Mattern, D. Lang, and J. Passlick-Deetjen Effect of dialysis flux and membrane material on dyslipidaemia and inflammation in haemodialysis patients Nephrol. Dial. Transplant., October 1, 2004; 19(10): 2570 - 2575. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Boure and R. Vanholder Which dialyser membrane to choose? Nephrol. Dial. Transplant., February 1, 2004; 19(2): 293 - 296. [Full Text] [PDF]
|
|
|
|
|
|
A. S. D. Vriese, M. Langlois, D. Bernard, I. Geerolf, L. Stevens, J. R. Boelaert, M. Schurgers, and E. Matthys Effect of dialyser membrane pore size on plasma homocysteine levels in haemodialysis patients Nephrol. Dial. Transplant., December 1, 2003; 18(12): 2596 - 2600. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. N. Friedman, A. G. Bostom, A. S. Levey, I. H. Rosenberg, J. Selhub, and A. Pierratos Plasma Total Homocysteine Levels among Patients Undergoing Nocturnal versus Standard Hemodialysis J. Am. Soc. Nephrol., January 1, 2002; 13(1): 265 - 268. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. N. FRIEDMAN, A. G. BOSTOM, J. SELHUB, A. S. LEVEY, and I. H. ROSENBERG The Kidney and Homocysteine Metabolism J. Am. Soc. Nephrol., October 1, 2001; 12(10): 2181 - 2189. [Abstract] [Full Text] [PDF]
|
|